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MR. MARK MITCHELL ROUBIDOUX II NP-C
NPI 1629685235
Nurse Practitioner in Lewiston, ID

Active since September 28, 2020PECOS EnrolledAccepts Medicare Assignment
336 WARNER DR STE 4A, LEWISTON, ID 83501(208) 305-3537(877) 376-4040 Get Directions Write a Review

NPPES record last updated: September 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 12, 2025, Jul 19, 2024, Sep 28, 2020 (3 updates tracked since 2020).

About Mr. Mark Mitchell Roubidoux Ii Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARK MITCHELL ROUBIDOUX II NP-C (NPI 1629685235) is an individual nurse practitioner in Lewiston, Idaho, licensed in Idaho (39235) and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1629685235
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. MARK MITCHELL ROUBIDOUX IICredential: NP-C
Location Address336 WARNER DR STE 4ALewiston, ID 83501-4441
Mailing Address320 E Neider Ave Ste 103Coeur D Alene, ID 83815-6007 · (208) 930-4944 · Fax (877) 376-4040
Phone(208) 305-3537
Fax(877) 376-4040
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateSeptember 28, 2020
Last NPPES UpdateSeptember 12, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 12, 2025
✔ NPI 1629685235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in ID · 39235
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
336 WARNER DR STE 4A, Lewiston, ID 83501
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Mark Mitchell Roubidoux Ii Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638577828
PECOS Enrollment IDI20220209002036
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Roubidoux's NPI number?

The NPI number for Mark Roubidoux is 1629685235. It was assigned to this individual provider in the NPPES registry on September 28, 2020.

Where is Mark Roubidoux located?

Mark Roubidoux practices at 336 Warner Dr Ste 4A, Lewiston, ID 83501. The listed phone number is (208) 305-3537.

What is Mark Roubidoux's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mark Roubidoux enrolled in Medicare?

Yes. Mark Roubidoux is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mark Roubidoux accept?

Health plans from Providence Health Plan list Mark Roubidoux as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Roubidoux was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.